Over the past 40 years in Australia, physicians have played a key role in reducing smoking rates, setting an example through their own smoking habits, as well as through the development of overall public health policy.1 Smoking rates among Australian physicians declined dramatically from high levels in the 1960s when about 1 in 3 physicians smoked, to about 1 in 10 by the late 1990s.2 A 2012 survey of staff at a Melbourne hospital found that smoking prevalence (7%) was lower than the general population.3 Another survey of metropolitan hospitals in South Australia found that prevalence among staff was lower than average in 2012 (8%), and had steadily declined over the past decade.4
The role of health professionals in providing effective medical interventions to help patients stop smoking is widely recognised. 2, 5-9 However, in countries that have high rates of smoking among physicians, the translation of knowledge about the dangers of smoking to patients within the health care setting is challenging.10 Physicians11, 12 and nurses13, 14 who are current smokers appear to be less likely to engage in cessation advice and counselling than former/never smokers.
Aboriginal and Torres Strait Islander health service staff have substantially higher smoking rates than non-Indigenous health workers—see section 8.3. A 2012–13 survey of such workers found that ex-smokers were significantly more likely to report being very much or extremely confident in talking to patients about quitting, compared with smokers (see also section 8.6).16
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1. Smith D and Leggat P. An international review of tobacco smoking in the medical profession: 1974-2004. BMC Public Health, 2007; 7(147):115. Available from: http://www.biomedcentral.com/content/pdf/1471-2458-7-115.pdf
2. Smith D and Leggat P. The historical decline of tobacco smoking among Australian physicians: 1964-1997. Tobacco Induced Diseases, 2008; 4(1):13. Available from: https://tobaccoinduceddiseases.biomedcentral.com/articles/10.1186/1617-9625-4-13
3. Rahman MA, Wilson AM, Sanders R, Castle D, Daws K, et al. Smoking behavior among patients and staff: A snapshot from a major metropolitan hospital in Melbourne, Australia. International Journal of General Medicine, 2014; 7:79–87. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24470770
4. Jones T and Williams J. Smoking prevalence and perspectives on smoking on campus by employees in Australian teaching hospitals. Internal Medicine Journal, 2012; 42(3):311–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20298510
5. Russell M, Wilson C, Taylor C, and Baker C. Effect of general practitioners' advice against smoking. British Medical Journal, 1979; 2(6184):231–5. Available from: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1595592&blobtype=pdf
6. Gray N and Daube M. Guidelines for smoking control. UICC technical report series no. 52, Geneva: International Union Against Cancer, 1980.
7. US Department of Health and Human Services. The health benefits of smoking cessation. A report of the Surgeon General. Atlanta, GA: Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990. Available from: https://profiles.nlm.nih.gov/nn/b/b/c/t/
8. Richmond R. Physicians can make a difference with smokers: Evidence-based clinical approaches. International Journal of Tuberculosis and Lung Disease, 1999; 3(2):100–12. Available from: http://www.ingentaconnect.com/content/iuatld/ijtld/1999/00000003/00000002/art00005?token=00591f58423dfb09016358f5c5f3b3b476728487434707b2a79427b5a4f582a2f4876753375686f49d4da963f
9. World Health Organization. Tools for advancing tobacco control in the xx1st century: Policy recommendations for smoking cessation and treatment of tobacco dependence. Tools for public health. Geneva: World Health Organization, 2003. Available from: http://www.who.int/tobacco/resources/publications/en/intro_chapter3.pdf
10. Ulbricht S, Baumeister S, Meyer C, Schmidt C, Schumann A, et al. Does the smoking status of general practitioners affect the efficacy of smoking cessation counselling? Patient Education and Counseling, 2009; 74(1):23-8. Available from: http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6TBC-4THJ6CD-1-5&_cdi=5139&_user=10&_orig=search&_coverDate=09%2F24%2F2008&_sk=999999999&view=c&wchp=dGLzVlz-zSkzV&md5=be17cfb0b6e0187d8e0bf6a0e0c255f1&ie=/sdarticle.pdf
11. Azuri J and Nashef S. Primary care physicians' characteristics and attitudes on smoking cessation. American Journal of Health Behavior, 2016; 40(5):578-84. Available from: http://www.ingentaconnect.com/content/png/ajhb/2016/00000040/00000005/art00004
12. Meshefedjian GA, Gervais A, Tremblay M, Villeneuve D, and O’Loughlin J. Physician smoking status may influence cessation counseling practices. Can J Public Health, 2010; 101(4):-196. Available from: http://journal.cpha.ca/index.php/cjph/article/view/2532
13. Kelly M, Wills J, and Sykes S. Do nurses’ personal health behaviours impact on their health promotion practice? A systematic review. International Journal of Nursing Studies; 76:62-77. Available from: http://dx.doi.org/10.1016/j.ijnurstu.2017.08.008
14. Duaso MJ, Bakhshi S, Mujika A, Purssell E, and While AE. Nurses' smoking habits and their professional smoking cessation practices. A systematic review and meta-analysis. Int J Nurs Stud, 2016; 67:3-11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27880873
15. Slama K, Karsenty S, and Hirsch A. French general practitioners’ attitudes and reported practices in relation to their participation and effectiveness in a minimal smoking cessation programme for patients. Addiction, 1999; 94:125-32.
16. Thomas DP, Davey ME, Panaretto KS, Hunt JM, Stevens M, et al. Smoking among a national sample of Aboriginal and Torres Strait Islander health service staff. Medical Journal of Australia, 2015; 202(10):S85-9. Available from: http://europepmc.org/abstract/MED/26017264